Introduction
With the advancement in surgical techniques and arthroscopic instrumentations, minimally invasive hand surgery has become the most popular treatment options for most common hand diseases. It has proven to have faster patient recovery and lower morbidity. These can be divided into arthroscopic surgery, endoscopic surgery and percutaneous soft tissue surgery.
Arthroscopic surgery
- Proximal interphalangeal joint (PIPJ) and Metacarpophalangeal joint (MCPJ) arthroscopy: indications include synovectomy for inflammatory arthritis, removal of loose bodies and osteophytes.
- Thumb carpometacarpal joint (CMCJ) arthroscopy: indications include synovectomy for inflammatory arthritis, assisted reduction in fracture fixation, hemi-trapeziectomy and fusion for osteoarthritis.
- Wrist arthroscopy: it has become the gold standard for detecting intra-articular pathology, including the cartilage status, ligament injury, and the triangular fibrocartilage complex (TFCC). It also has an important role in the treatment of intra-articular distal radius fracture and other carpal bones fracture.
Endoscopic carpal tunnel release
Endoscopic carpal tunnel release has become the current trend in treating carpal tunnel syndrome. Its advantages include: reduced postoperative pain, faster recovery and earlier return to work and fewer wound-related complications such as scar tenderness.
Percutaneous soft tissue surgery
1) Percutaneous trigger finger release - Percutaneous technique by using a needle can accomplish the same surgical result as traditional open surgery with faster recovery and better surgical outcome.
2) Percutaneous fasciotomy for Dupuytren’s contracture - Percutanous fasciotomy for Dupuytren’s contracture can be performed by using a needle under local anaesthesia. It has a lower incidence of nerve injury and reflex sympathetic dystrophy. It also has a faster recovery and less wound complications.
Advantages of Minimally invasive surgery
Advantages include: 1) less post-op wound pain, 2) faster rehabilitation and recovery, 3) less surrounding soft tissue adhesion, 4) better preservation of surrounding vascularity and 5) better cosmesis.
Co-location with:
